[Abstract + References] The impact of maternal epilepsy on delivery and neonatal outcomes



Epilepsy is a common neurological disorder that may complicate reproductive health. Our aim in this study was to provide prospective ascertainment of obstetric and neonatal outcomes in women with epilepsy and investigate whether the risk of pregnancy, delivery, and neonatal complications differed between women with epilepsy and women without epilepsy.


Pregnant women with epilepsy and women without epilepsy (control group) were prospectively evaluated during the years 2013–2018. They were regularly followed by a neurologist and obstetrician until the end of pregnancy.


Delivery and perinatal outcomes were compared between 112 women diagnosed with epilepsy and 277 women without epilepsy. Epilepsy was a significant risk factor for preterm delivery, cesarean section, fetal hypoxia, and Apgar score ≤ 7 at 5 min in offspring (odds ratio (OR) = 2.83, 95% confidence interval (CI) 1.03–7.76; OR = 5.61, 95% CI 3.44–9.14; OR = 1.81, 95% CI 1.08–3.04; OR = 8.12, 95% CI 4.04–16.35, respectively). Seizures during pregnancy had influence on the preference of cesarean section as a mode of delivery (ОR = 3.39; 95% CI 1.40–8.17). The rate of perinatal hypoxia was significantly higher in children born by cesarean section (ОR = 2.84; 95% CI 1.04–7.76). There was no significant difference between women with epilepsy and controls in malformation rate.


Women with epilepsy had an increased risk of pregnancy and delivery complications. Cesarean section was associated with an increased risk of complications in offspring.



  1. 1.
    Harden C (2008) Antiepileptic drug teratogenesis: what are the risks for congenital malformations and adverse cognitive outcomes? Int Rev Neurobiol 83:205–213.  https://doi.org/10.1016/S0074-7742(08)00011-1CrossRefPubMedGoogle Scholar
  2. 2.
    Bromley R, Baker G (2017) Fetal antiepileptic drug exposure and cognitive outcomes. Seizure 44:225–231.  https://doi.org/10.1016/j.seizure.2016.10.006CrossRefPubMedGoogle Scholar
  3. 3.
    Leach J, Smith P, Craig J, Bagary M, Cavanagh D, Duncan S et al (2017) Epilepsy and pregnancy: for healthy pregnancies and happy outcomes. Suggestions for service improvements from the Multispecialty UK Epilepsy Mortality Group. Seizure 50:67–72.  https://doi.org/10.1016/j.seizure.2017.05.004CrossRefPubMedGoogle Scholar
  4. 4.
    Borthen I, Eide M, Veiby G, Daltveit A, Gilhus N (2009) Complications during pregnancy in women with epilepsy: population-based cohort study. BJOG 116(13):1736–1742.  https://doi.org/10.1111/j.1471-0528.2009.02354.xCrossRefPubMedGoogle Scholar
  5. 5.
    Artama M, Braumann J, Raitanen J, Uotila J, Gissler M, Isojärvi J et al (2017) Women treated for epilepsy during pregnancy: outcomes from a nationwide population-based cohort study. Acta Obstet Gynaecol Scand 96(7):812–820.  https://doi.org/10.1111/aogs.13109CrossRefGoogle Scholar
  6. 6.
    Borthen I, Eide M, Daltveit A, Gilhus N (2010) Delivery outcome of women with epilepsy: a population-based cohort study. BJOG 117:1537–1543.  https://doi.org/10.1111/j.1471-0528.2010.02694.xCrossRefPubMedGoogle Scholar
  7. 7.
    Borthen I (2015) Obstetrical complications in women with epilepsy. Seizure 28:32–34.  https://doi.org/10.1016/j.seizure.2015.02.018CrossRefPubMedGoogle Scholar
  8. 8.
    Sveberg L, Svalheim S, Taubøll E (2015) The impact of seizures on pregnancy and delivery. Seizure 28:35–38.  https://doi.org/10.1016/j.seizure.2015.02.020CrossRefPubMedGoogle Scholar
  9. 9.
    Razaz N, Tomson T, Wikström A, Cnattingius S (2017) Association between pregnancy and perinatal outcomes among women with epilepsy. JAMA Neurol 74(8):983–991.  https://doi.org/10.1001/jamaneurol.2017.1310CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Hiilesmaa V, Bardy A, Teramo K (1985) Obstetric outcome in women with epilepsy. Am J Obstet Gynecol 152(5):499–504CrossRefGoogle Scholar
  11. 11.
    Viinikainen K, Heinonen S, Eriksson K, Kälviäinen R (2006) Community-based, prospective, controlled study of obstetric and neonatal outcome of 179 pregnancies in women with epilepsy. Epilepsia 47:186–192.  https://doi.org/10.1111/j.1528-1167.2006.00386.xCrossRefPubMedGoogle Scholar
  12. 12.
    Richmond J, Krishnamoorthy P, Andermann E, Benjamin A (2004) Epilepsy and pregnancy: an obstetric perspective. Am J Obstet Gynecol 190(2):371–379CrossRefGoogle Scholar
  13. 13.
    Pilo C, Wide K, Winbladh B (2006) Pregnancy, delivery, and neonatal complications after treatment with antiepileptic drugs. Acta Obstet Gynecol Scand 85:643–646.  https://doi.org/10.1080/00016340600604625CrossRefPubMedGoogle Scholar
  14. 14.
    Thomas S, Sindhu K, Ajaykumar B, Sulekha D, Sujamol J (2009) Maternal and obstetric outcome on in women with epilepsy. Seizure 18(3):163–166.  https://doi.org/10.1016/j.seizure.2008.08.010CrossRefPubMedGoogle Scholar
  15. 15.
    Hvas C, Henriksen T, Оstergaard J, Mogens D (2000) Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight. Br J Obstet Gynaecol 107:896–902CrossRefGoogle Scholar
  16. 16.
    Yerby MS (2000) Quality of life, epilepsy advances, and the evolving role of anticonvulsants in women with epilepsy. Neurology 55(5 Suppl 1):21–31 discussion S 54-8Google Scholar
  17. 17.
    Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E, Sabers A, Thomas SV, Vajda F, EURAP Study Group (2015) Antiepileptic drugs and intrauterine death: a prospective observational study from EURAP. Neurology 85(7):580–588.  https://doi.org/10.1212/WNL.0000000000001840CrossRefPubMedGoogle Scholar
  18. 18.
    Kasradze S, Gogatishvili N, Lomidze G, Ediberidze T, Lazariashvili M, Khomeriki K, Mamukadze S, Metreveli M, Gagoshidze T, Tatishvili N, Tomson T (2017) Cognitive functions in children exposed to antiepileptic drugs in utero – study in Georgia. Epilepsy Behav 66:105–112.  https://doi.org/10.1016/j.yebeh.2016.10.014CrossRefPubMedGoogle Scholar
  19. 19.
    Katz O, Levy A, Wiznitzer A, Sheiner E (2006) Pregnancy and perinatal outcome in epileptic women: a population-based study. J Matern Fetal Neonatal Med 19(1):21–25.  https://doi.org/10.1080/14767050500434096CrossRefPubMedGoogle Scholar
  20. 20.
    Shahla M, Hijran B, Sharif M (2018) The course of epilepsy and seizure control in pregnant women. Acta Neurol Belg 118:459–464.  https://doi.org/10.1007/s13760-018-0974-0CrossRefPubMedGoogle Scholar
  21. 21.
    Thomas S, Syam U, Devy J (2012) Predictors of seizures during pregnancy in women with epilepsy. Epilepsia 53(5):e85–e88.  https://doi.org/10.1111/j.1528-1167.2012.03439.xCrossRefGoogle Scholar
  22. 22.
    Ozdemir O, Mustafa E, Aslihan K, Selimova V, Atalay C (2015) Pregnancy outcome of 149 pregnancies in women with epilepsy: experience from a tertiary care hospital. Interv Med Appl Sci 7(3):108–113.  https://doi.org/10.1556/1646.7.2015.3.4CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Vajda F, O’Brien T, Graham J, Hitchcock A, Lander C, Eadie M (2018) Predicting epileptic seizure control during pregnancy. Epilepsy Behav 78:91–95.  https://doi.org/10.1016/j.yebeh.2017.10.017CrossRefPubMedGoogle Scholar
  24. 24.
    Soontornpun A, Choovanichvong T, Tongsong T (2018) Pregnancy outcomes among women with epilepsy: a retrospective cohort study. Epilepsy Behav 82:52–56.  https://doi.org/10.1016/j.yebeh.2018.03.001CrossRefPubMedGoogle Scholar
  25. 25.
    Borthen I, Eide M, Daltveit A, Gilhus N (2011) Obstetric outcome in women with epilepsy: a hospital-based, retrospective study. BJOG 118(8):956–965.  https://doi.org/10.1111/j.1471-0528.2011.03004.xCrossRefPubMedGoogle Scholar
  26. 26.
    Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, Mccorry D, Bagary M, EBM CONNECT Collaboration et al (2015) Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 386(10006):1845–1852.  https://doi.org/10.1016/S0140-6736(15)00045-8CrossRefPubMedGoogle Scholar
  27. 27.
    Kusznir Vitturi B, Barreto Cabral F, Mella Cukiert C (2019) Outcomes of pregnant women with refractory epilepsy. Seizure 69:251–257CrossRefGoogle Scholar
  28. 28.
    MacDonald S, Bateman B, McElrath T, Hernández-Díaz S (2015) Mortality and morbidity during delivery hospitalization among pregnant women with epilepsy in the United States. JAMA Neurol 72(9):981–988.  https://doi.org/10.1001/jamaneurol.2015.1017CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Vajda F, O’Brien T, Graham J, Hitchcock A, Kuhn Viale L, Allotey JR, Lander C, Eadie M (2018) Cesarean section in Australian women with epilepsy. Epilepsy Behav 89:126–129.  https://doi.org/10.1016/j.yebeh.2018.10.008CrossRefPubMedGoogle Scholar
  30. 30.
    Veiby G, Daltveit A, Engelsen B, Gilhus N (2009) Pregnancy, delivery, and outcome for the child in maternal epilepsy. Epilepsia 50(9):2130–2139.  https://doi.org/10.1111/j.1528-1167.2009.02147.xCrossRefPubMedGoogle Scholar
  31. 31.
    Tollanes M (2009) Increased rate of caesarean sections – causes and consequences. Tidsskr Nor Legeforen 129:1329–1331.  https://doi.org/10.4045/tidsskr.08.0453CrossRefGoogle Scholar
  32. 32.
    Kolas T, Hofoss D, Daltveit A, Nilsen S, Henriksen T, Häger R et al (2003) Indications for cesarean deliveries in Norway. Am J Obstet Gynecol 188:864–870CrossRefGoogle Scholar
  33. 33.
    Othman N, Rahman A (2013) Obstetric and birth outcomes in pregnant women with epilepsy: a hospital-based study. Ann Indian Acad Neurol 16:534–537.  https://doi.org/10.4103/0972-2327.120458CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Chen Y, Chiou H, Lin H, Lin H (2009) Affect of seizures during gestation on pregnancy outcomes in women with epilepsy. Arch Neurol 66(8):979–984.  https://doi.org/10.1001/archneurol.2009.142CrossRefPubMedGoogle Scholar
  35. 35.
    Christensen J, Pedersen H, Kjaersgaard M, Parner E, Vestergaard M, Sørensenet M et al (2015) Apgar-score in children prenatally exposed to antiepileptic drugs: a population-based cohort study. BMJ Open 5:e007425.  https://doi.org/10.1136/bmjopen-2014-007425CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Farmen A, Grundt J, Nakling J, Mowinckel P, Nakken K, Lossius M (2019) Increased rate of acute caesarean sections in women with epilepsy: results from the Oppland Perinatal Database in Norway. Eur J Neurol 26(4):617–623.  https://doi.org/10.1111/ene.13865CrossRefPubMedGoogle Scholar
  37. 37.
    Liporace J, D’Abreu A (2003) Epilepsy and women’s health: family planning, bone health, menopause, and menstrual-related seizures. Mayo Clin Proc78 78:497–506CrossRefGoogle Scholar
  38. 38.
    Rauchenzauner M, Ehrensberger M, Prieschl M, Kapelari K, Bergmann M, Walser G, Neururer S, Unterberger I, Luef G (2013) Generalized tonic-clonic seizures and antiepileptic drugs during pregnancy – a matter of importance for the baby? J Neurol 260:484–488.  https://doi.org/10.1007/s00415-012-6662-8CrossRefPubMedGoogle Scholar
  39. 39.
    Quiroz L, Chang H, Blomquist J, Okoh Y, Handa V (2008) Scheduled cesarean delivery: maternal and neonatal risks in primiparous women in a community hospital setting. Am J Perinatol 26(4):271–277.  https://doi.org/10.1055/s-0028-1103155CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Kamath B, Todd J, Glazner J, Lezotte D, Lynch A (2009) Neonatal outcomes after elective cesarean delivery. Obstet Gynecol 113(6):1231–1238.  https://doi.org/10.1097/AOG.0b013e3181a66d57ıCrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Pennell PB (2008) Antiepileptic drugs during pregnancy: what is known and which AEDs seem to be safest? Epilepsia 49(Suppl 9):43–55.  https://doi.org/10.1111/j.1528-1167.2008.01926.xCrossRefPubMedGoogle Scholar
  42. 42.
    Tomson T, Xue H, Battino D (2015) Major congenital malformations in children of women with epilepsy. Seizure 28:46–50.  https://doi.org/10.1016/j.seizure.2015.02.019CrossRefPubMedGoogle Scholar
  43. 43.
    Galappatthy P, Liyanage CK, Lucas MN et al (2018) Obstetric outcomes and effects on babies born to women treated for epilepsy during pregnancy in a resource limited setting: a comparative cohort study. BMC Pregnancy Childbirth 18(1):230.  https://doi.org/10.1186/s12884-018-1857-3CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Battino D, Tomson T, Bonizzon E, Craig J, Lindhout D, Sabers A et al (2013) Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry. Epilepsia 54(9):1621–1627.  https://doi.org/10.1111/epi.12302CrossRefPubMedGoogle Scholar
  45. 45.
    Mawhinney E, Craig J, Morrow J, Russell A, Smithson W, Parsons L, Morrison PJ, Liggan B, Irwin B, Delanty N, Hunt SJ (2013) Levetiracetam in pregnancy: results from the UK and Ireland epilepsy and pregnancy registers. Neurology 80(4):400–405.  https://doi.org/10.1212/WNL.0b013e31827f0874CrossRefPubMedGoogle Scholar
  46. 46.
    Kazemi M, Salehi M, Kheirollahi M (2016) Down syndrome: current status, challenges and future perspectives. Int J Mol Cell Med 5(3):125–133PubMedPubMedCentralGoogle Scholar
  47. 47.
    Veiby G, Bjørk M, Engelsen B, Gilhus N (2015) Epilepsy and recommendations for breastfeeding. Seizure 28:57–65.  https://doi.org/10.1016/j.seizure.2015.02.013CrossRefPubMedGoogle Scholar
  48. 48.
    Stephen L, Harden C, Tomson T, Brodie M (2019) Management of epilepsy in women. Lancet Neurol 18(5):481–491.  https://doi.org/10.1016/S1474-4422(18)30495-2CrossRefPubMedGoogle Scholar
  49. 49.
    He S, Zhu H, Qiu X, Zhu X, Peng A, Duan J, Chen L (2017) Pregnancy outcome in women with epilepsy in Western China: a prospective hospital based study. Epilepsy Behav 74:10–14.  https://doi.org/10.1016/j.yebeh.2017.05.034CrossRefPubMedGoogle Scholar
  50. 50.
    Johnson E, Burke A, Wang A, Pennell P (2018) Unintended pregnancy, prenatal care, newborn outcomes, and breastfeeding in women with epilepsy. Neurology 91(11):e1031–e1039.  https://doi.org/10.1212/WNL.0000000000006173CrossRefPubMedGoogle Scholar

via The impact of maternal epilepsy on delivery and neonatal outcomes | SpringerLink

, , , , , ,

  1. Leave a comment

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: